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Individual

MINGQUAN TONGBHAKDEE SUKSANONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1752 MLK JR ST N, ST PETERSBURG, FL 33704-4206
(727) 823-7224
(727) 489-9486
Mailing address
PO BOX 1945, PALM HARBOR, FL 34682-1945
(727) 771-1300
(727) 781-2300

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
ME0031666
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
059830500
FL
01
160184600
WORK COMP
FL
01
52999
BCBS
FL
01
P00883306
RAILROAD MEDICARE
FL
Enumeration date
03/29/2006
Last updated
05/01/2012
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